Calculating the workforce in general surgery

Objective. —To provide a reasonable estimate of the patient care and resident physician workforce practicing general surgery in 1994. Design. —Data regarding general surgical residents and practicing general surgeons were obtained from four sources and compared with previously published numbers. Data Sources. —Information was derived from the American College of Surgeons'Longitudinal Study of Surgical Residents: 1992-1993; the American Medical Association'sPhysician Characteristics and Distribution in the United States, 1994 Edition; the American Board of Medical Specialties' database on general surgeons; and the American Board of Surgery recertification data from the files of diplomates since 1968. Each of these sources was analyzed separately to derive a count of graduates from general surgery residency programs and an estimate of fully trained general surgeons engaged in patient care activities. Results. —We found that approximately 600 graduates of general surgery residency programs enter the practice of general surgery each year, and we found a close correlation between maximum and minimum estimates of the number of fully trained general surgeons engaged in active patient care, certified general surgeons who are not retired, and currently certified general surgeons. This number (17289 to 23 502) is approximately half that commonly used in calculations of the general surgery workforce (38 239). The larger number includes surgeons with subspecialty training beyond general surgery, surgical residents, and surgeons not engaged in patient care. Conclusions. —Estimations of the workforce in general surgery and predictions of future needs for general surgeons must be derived from the appropriate number of general surgery residents and practicing general surgeons. (JAMA. 1995;274:731-734)